A nurse is caring for a client who is coming in for her first prenatal visit and it is estimated to be 9 weeks gestation.
An ultrasound is scheduled.
The nurse should explain to the client that the ultrasound is being done today to assess for which of the following?
Chromosomal defect.
Fetal lung maturity.
Fetal heartbeat.
Fetal position in utero.
The Correct Answer is C
Choice A rationale
Chromosomal defects are typically assessed using different tests, such as chorionic villus sampling or amniocentesis, rather than an ultrasound at this early stage.
Choice B rationale
Fetal lung maturity cannot be assessed at 9 weeks gestation because the lungs are not yet developed. This assessment is usually done later in pregnancy if preterm delivery is anticipated.
Choice C rationale
At 9 weeks gestation, the primary purpose of an ultrasound is to confirm the presence of a fetal heartbeat, which indicates a viable pregnancy.
Choice D rationale
The position of the fetus in utero is not a concern at this early stage of pregnancy. Fetal positioning becomes relevant later in pregnancy, closer to delivery.
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Correct Answer is A
Explanation
Choice A rationale
Administering betamethasone 12 mg IM helps accelerate fetal lung maturity by stimulating the production of surfactant. This is crucial for a preterm baby, as immature lungs are one of the biggest risks in preterm labor. Administering betamethasone can significantly improve neonatal outcomes by reducing respiratory distress syndrome and other complications related to prematurity.
Choice B rationale
Preparing the client for immediate delivery is not the first action as the primary goal in managing preterm labor with an L/S ratio of 1: is to delay labor and enhance fetal lung maturity. Betamethasone administration is prioritized to maximize fetal lung development before considering delivery.
Choice C rationale
Administering hydralazine 25 mg IV is used to manage hypertension and is unrelated to enhancing fetal lung maturity in preterm labor. It is not indicated in this situation as the primary concern is not managing blood pressure.
Choice D rationale
Infusing a bolus of IV fluid might be used to manage preterm labor but does not directly address the need to improve fetal lung maturity. The main priority is administering steroids like betamethasone to expedite fetal lung development.
Correct Answer is C
Explanation
Choice A rationale
The sex of the fetus can be determined earlier through ultrasound or blood tests, making amniocentesis at 36 weeks unnecessary for this purpose.
Choice B rationale
Detection of metabolic disorders can also be done earlier in the pregnancy through other tests. Amniocentesis at 36 weeks is not typically used for this purpose.
Choice C rationale
Determining fetal lung maturity is a primary reason for performing an amniocentesis at 36 weeks gestation. This test assesses whether the fetus's lungs are developed enough for the baby to breathe independently after birth.
Choice D rationale
Identification of abnormal fetal cells can be done earlier in pregnancy through amniocentesis or other genetic tests. It is not the primary reason for amniocentesis at 36 weeks.
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